Search results for: digital patient passport

Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: Roman Graf, Sergiu Gordea, Heather M. Ryan

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This paper presents an approach for easy creation and classification of institutional risk profiles supporting endangerment analysis of file formats. The main contribution of this work is the employment of data mining techniques to support set up of the most important risk factors. Subsequently, risk profiles employ risk factors classifier and associated configurations to support digital preservation experts with a semi-automatic estimation of endangerment group for file format risk profiles. Our goal is to make use of an expert knowledge base, accuired through a digital preservation survey in order to detect preservation risks for a particular institution. Another contribution is support for visualisation of risk factors for a requried dimension for analysis. Using the naive Bayes method, the decision support system recommends to an expert the matching risk profile group for the previously selected institutional risk profile. The proposed methods improve the visibility of risk factor values and the quality of a digital preservation process. The presented approach is designed to facilitate decision making for the preservation of digital content in libraries and archives using domain expert knowledge and values of file format risk profiles. To facilitate decision-making, the aggregated information about the risk factors is presented as a multidimensional vector. The goal is to visualise particular dimensions of this vector for analysis by an expert and to define its profile group. The sample risk profile calculation and the visualisation of some risk factor dimensions is presented in the evaluation section.

Keywords: linked open data, information integration, digital libraries, data mining

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Authors: Florge Francis A. Sy

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Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

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Authors: Amandeep Kaur

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Digital Image processing is a fundamental tool to perform various operations on the digital images for pattern recognition, noise removal and feature extraction. In this paper noise removal technique has been described for various types of noises. This paper comprises discussion about various noises available in the image due to different environmental, accidental factors. In this paper, various de-noising approaches have been discussed that utilize different wavelets and filters for de-noising. By analyzing various papers on image de-noising we extract that wavelet based de-noise approaches are much effective as compared to others.

Keywords: de-noising techniques, edges, image, image processing

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Authors: Carla Aramouny

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Digital fabrication, between advancements in software and machinery, is pushing practice today towards more complexity in design, allowing for unparalleled explorations. It is giving designers the immediate capacity to apply their imagined objects into physical results. Yet at no time have questions of material knowledge become more relevant and crucial, as technological advancements approach a radical re-invention of the design process. As more and more designers look towards tactile crafts for material know-how, an interest in natural behaviors has also emerged trying to embed intelligence from nature into the designed objects. Concerned with enhancing their immediate environment, designers today are pushing the boundaries of design by bringing in natural systems, materiality, and advanced fabrication as essential processes to produce active designs. New Territories, a yearly architecture and design course on digital design and materiality, allows students to explore processes of digital fabrication in intersection with natural systems and hands-on experiments. This paper will highlight the importance of learning from nature and from physical materiality in a digital design process, and how the simultaneous move between the digital and physical realms has become an essential design method. It will detail the work done over the course of three years, on themes of natural systems, crafts, concrete plasticity, and active composite materials. The aim throughout the course is to explore the design of products and active systems, be it modular facades, intelligent cladding, or adaptable seating, by embedding current digital technologies with an understanding of natural systems and a physical know-how of material behavior. From this aim, three main themes of inquiry have emerged through the varied explorations across the three years, each one approaching materiality and digital technologies through a different lens. The first theme involves crossing the study of naturals systems as precedents for intelligent formal assemblies with traditional crafts methods. The students worked on designing performative facade systems, starting from the study of relevant natural systems and a specific craft, and then using parametric modeling to develop their modular facades. The second theme looks at the cross of craft and digital technologies through form-finding techniques and elastic material properties, bringing in flexible formwork into the digital fabrication process. Students explored concrete plasticity and behaviors with natural references, as they worked on the design of an exterior seating installation using lightweight concrete composites and complex casting methods. The third theme brings in bio-composite material properties with additive fabrication and environmental concerns to create performative cladding systems. Students experimented in concrete composites materials, biomaterials and clay 3D printing to produce different cladding and tiling prototypes that actively enhance their immediate environment. This paper thus will detail the work process done by the students under these three themes of inquiry, describing their material experimentation, digital and analog design methodologies, and their final results. It aims to shed light on the persisting importance of material knowledge as it intersects with advanced digital fabrication and the significance of learning from natural systems and biological properties to embed an active performance in today’s design process.

Keywords: digital fabrication, design and craft, materiality, natural systems

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Authors: Jaspinder Kaur, Jatinder Pal Singh

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Introduction- Delusional parasitosis is a rare psychotic illness characterized by a fixed belief of manifesting a parasite in a body when in reality, it was not. Also known as Ekbom syndrome or delusional infestations, or acarophobia. Although the patient has no primary skin pathology, but all skin findings were secondary to skin manipulation by the patient itself, which is why up to 90% of patients first seek consultation from a dermatologist. Most commonly, it was seen in older people with female to male ratio is 2:1. For treatment, the patient first need to be investigated to rule all other possible causes, as Delusional parasitosis can be caused by Vitamin B12 deficiency, pellagra, hepatic and renal disease, diabetes mellitus, multiple sclerosis, and leprosy. When all possible causes ruled out, psychiatric referral to be done. Rule out other psychiatric comorbidities, and treatment should be done accordingly. Patient with delusional parasitosis responds well to second generation antipsychotics and need to continuous medication over years, and relapse is likely if treatment is stopped. Case Presentation- A 79-year-old female, belonging to lower socio-economic status, presented with complaints of itching sensation with erythematous patches over the scalp and multiple scratch excoriations lesion over the scalp, face and neck from the past 7-8 months. She had a feeling of small insect crawling under her skin and scalp area. To reduce the itching and kill the insect, she would scratch and squeeze her skin repeatedly. When the family tried to give her explanation that there was no insect in her body, she would not get convinced, rather got angry and abuse family members for not believing her. Gradually, her sleep would remain disturbed, she would be seen awake at night, seen to be scratching her skin, pull her scalp hair, even squeeze out her healed lesions. She collected her skin debris, scalp hairs and look out for insect. Because of her continuous illness, the patient started to remain sad and had crying spells. Her appetite decreased. She became socially isolated and stopped doing her activities of daily living. Family member’s first consulted dermatologist, investigated thoroughly with routine investigations, autoimmune and malignancy workup. As all investigations were normal, following which patient was referred for psychiatric evaluation. The patient was started on Tablet Olanzapine 2.5 mg, gradually increased to 7.5 mg. Over 1 month, there was reduction in itching, skin pricking. Lesions were gradually healed, and the patient continued to take other dermatological medications and ointment and was in regular follow up with psychiatric liaison from past 2 months with 70-80 % improvement in her symptoms. Conclusion- Delusional parasitosis is a psychiatric disorder of insidious onset, seen commonly in middle and old age people. Both psychiatric and dermatology consultation liaison will help the patient for an early diagnosis and adequate treatment. If a primary psychiatric diagnosis, the patient respond well to second generation antipsychotics but always require a further evaluation and treatment management if it is secondary to some physical or other psychiatric comorbidity.

Keywords: delusional parasitosis, delusional infestations, rare, primary psychiatric diagnosis, antipsychotic agents

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Authors: Juan Torralba

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Student digital artifacts were investigated, utilizing a qualitative exploratory research design to understand the ways in which students represented their knowledge of seventh-grade proportionality concepts as they participated in maker-based activities that culminated in the creation of digital 3-dimensional models of their dream homes. Representations of the geometric and numeric dimensions of proportionality were analyzed in the written, verbal, and visual data collected from the students. A directed content analysis approach was utilized in the data analysis, as this work aimed to build upon existing research in the field of maker-based STEAM Education. The results from this work show that students can represent their understanding of proportional reasoning through open-ended written responses more accurately than through verbal descriptions or digital artifacts. The geometric and numeric dimensions of proportionality and their respective components of attributes of similarity representation and percents, rates, and ratios representations were the most represented by the students than any other across the data, suggesting a maker-based instructional approach to teaching proportionality in the middle grades may be promising in helping students gain a solid foundation in those components. Recommendations for practice and research are discussed.

Keywords: learning through making, maker-based education, maker education in the middle grades, making in mathematics, the maker movement

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Kerem Ok, Serafettin Senturk, Serdar Aktas, Cem Cevikbas

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Mobile technology is very popular nowadays and it provides a digital world where users can experience many value-added services. Service Providers are also eager to offer diverse value-added services to users such as digital identity, mobile financial services and so on. In this context, the security of data storage in smartphones and the security of communication between the smartphone and service provider are critical for the success of these services. In order to provide the required security functions, the SIM card is one acceptable alternative. Since SIM cards include a Secure Element, they are able to store sensitive data, create cryptographically secure keys, encrypt and decrypt data. In this paper, we design and implement a SIM and a smartphone framework that uses a SIM card for secure key generation, key storage, data encryption, data decryption and digital signing for mobile financial services. Our frameworks show that the SIM card can be used as a controlled Secure Element to provide required security functions for popular e-services such as mobile financial services.

Keywords: SIM card, mobile financial services, cryptography, secure data storage

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Ruwen Pei

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In the rapidly evolving landscape of the digital economy, platform employment has emerged as a transformative labor force, fundamentally altering the traditional paradigms of the employer-employee relationship. This paper provides a comprehensive analysis of the unique dynamics and intricate legal challenges associated with platform work, where workers often navigate precarious labor conditions without the robust safety nets typically afforded in traditional industries. It underscores the limitations of current labor regulations, particularly in addressing pressing concerns such as income volatility and disparate benefits. By drawing insights from diverse global case studies, this study emphasizes the compelling need for platform companies to shoulder their social welfare responsibilities, ensuring fair treatment and security for their workers. Moreover, it critically examines the profound influence of socio-cultural factors and educational awareness on the platform economy, shedding light on the complexities of this emerging labor landscape. Advocating for a harmonious equilibrium between flexibility and security, this paper calls for substantial legal reforms and innovative policy initiatives that can adapt to the evolving nature of work in the digital age. Finally, it anticipates forthcoming trends in the digital economy and platform labor relations, underscoring the significance of proactive adaptation to foster equitable and inclusive employment practices.

Keywords: platform employment, labor protections, social welfare, legal reforms, digital economy

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Authors: Peter Burggräf, Matthias Dannapfel, Hanno Voet, Patrick-Benjamin Bök, Jérôme Uelpenich, Julian Hoppe

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The increasing digitalization of value chains can help companies to handle rising complexity in their processes and thereby reduce the steadily increasing planning and control effort in order to raise performance limits. Due to technological advances, companies face the challenge of smart value chains for the purpose of improvements in productivity, handling the increasing time and cost pressure and the need of individualized production. Therefore, companies need to ensure quick and flexible decisions to create self-optimizing processes and, consequently, to make their production more efficient. Lean production, as the most commonly used paradigm for complexity reduction, reaches its limits when it comes to variant flexible production and constantly changing market and environmental conditions. To lift performance limits, which are inbuilt in current value chains, new methods and tools must be applied. Digitalization provides the potential to derive these new methods and tools. However, companies lack the experience to harmonize different digital technologies. There is no practicable framework, which instructs the transformation of current value chains into digital pervasive value chains. Current research shows that a connection between lean production and digitalization exists. This link is based on factors such as people, technology and organization. In this paper, the introduced method for the determination of digitally pervasive value chains takes the factors people, technology and organization into account and extends existing approaches by a new dimension. It is the first systematic approach for the digital transformation of lean production and consists of four steps: The first step of ‘target definition’ describes the target situation and defines the depth of the analysis with regards to the inspection area and the level of detail. The second step of ‘analysis of the value chain’ verifies the lean-ability of processes and lies in a special focus on the integration capacity of digital technologies in order to raise the limits of lean production. Furthermore, the ‘digital evaluation process’ ensures the usefulness of digital adaptions regarding their practicability and their integrability into the existing production system. Finally, the method defines actions to be performed based on the evaluation process and in accordance with the target situation. As a result, the validation and optimization of the proposed method in a German company from the electronics industry shows that the digital transformation of current value chains based on lean production achieves a raise of their inbuilt performance limits.

Keywords: digitalization, digital transformation, Industrie 4.0, lean production, value chain

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Authors: Pei Zhao, Sara Sintonen, Heikki Kynäslahti

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Digital museums and arts galleries have become popular in museum education and management. Museum and arts galleries website is one of the most effective and efficient ways. Google, a corporation specializing in Internet-related services and projects, not only puts high-resolution arts images online, but also uses augmented-reality in digital art gallery. The Google Art Project, Google’s production, provides users a platform in appreciating and learning arts. After Google Art Project, more and more countries released their own museum and arts gallery websites, like British Paining in BBC, and FINNA in Finland. Pedagogical function in these websites is one of the most important functions. In this paper, we use Google Art Project and FINNA as the case studies to investigate what kinds of pedagogical functions exist in these websites. Finally, this paper will give the recommendation to digital museums and websites development, especially the pedagogical functions development, in the future.

Keywords: arts education, cultural-heritage education, education with ICTs, pedagogical functions

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Authors: Yoshitaka Ooya, Daishuke Furuya, Manabu Nemoto

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Some countries such as Canada and Australia have mandatory bicycle helmet laws for all citizens and age groups. As of 2008 Japan has also adopted a helmet law but it is restricted to people 13 years old and under. People over 13 years of age are not required to wear helmets in Japan. Currently, the rate that people 0-13 years old actually wear helmets is low. In 2013 a number of patients came to Saitama University Hospital International Medical Center for treatment due to bicycle-related trauma. The total number of patients was 89 (55 male and 34 female). The average age of the patients was 40.9 years old (eldest; 83 y/o, median; 40 y/o, youngest; 1 y/o with a standard deviation ± 2.8). 54 of these patients (61%) experienced head trauma as well as some experiencing multiple injuries associated with their accident. 13 patients were wearing helmets, 50 patients were not wearing helmets and it is unknown if the remaining 26 patients were wearing helmets. This information was acquired from the patient`s medical charts. Only one patient who was wearing a helmet had a severe head injury, and this patient also experienced other multiple injuries. 17 patients who were not wearing helmets had severe head injuries and out of the 17, two had multiple injuries. The mechanism for injury varied. 12 patients were injured in an accident with a vehicle, only one of which was wearing a helmet. This patient also had multiple injuries. Of the other 11 patients, two had multiple injuries. The remaining patient`s injuries were caused by other accidents (3; fell over while riding, 2; crashed into an inanimate object, 1; collided with a motorcycle). The ladder of which had a severe head injury. All of these patients had light energy accidents and were all over 13 years of age. In Japan it is not mandatory for people over the age of 13 years to wear a bicycle helmet. Research shows that light energy accidents were mostly present in people over the age of 13, to which the law does not require the wearing of helmets. It is important that all people in all age groups be required to wear helmets when operating a bicycle to reduce the rate of light energy severe head injuries.

Keywords: bicycle helmet, head trauma, hospital, traumatic situation

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Juraj Londák, Radoslav Vargic, Pavol Podhradský

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In this contribution, we focus on the technical and economic aspects of using hybrid storage in microgrids for peak shaving. We perform a feasibility analysis of hybrid storage consisting of conventional supercapacitors and chemical batteries. We use multiple real-life consumption profiles from various industry-oriented microgrids. The primary purpose is to construct a digital twin model for reserved capacity simulation and prediction. The main objective is to find the equilibrium between technical innovations, acquisition costs and energy cost savings

Keywords: microgrid, peak shaving, energy storage, digital twin

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Authors: Huidan Yu, Anurag Deb, Rou Chen, I-Wen Wang

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The use of left ventricle assist devices (LVADs) in patients with heart failure has been a proven and effective therapy for patients with severe end-stage heart failure. Due to the limited availability of suitable donor hearts, LVADs will probably become the alternative solution for patient with heart failure in the near future. While the LVAD is being continuously improved toward enhanced performance, increased device durability, reduced size, a better understanding of implantation management becomes critical in order to achieve better long-term blood supplies and less post-surgical complications such as thrombi generation. Important issues related to the LVAD implantation include the location of outflow grafting (OG), the angle of the OG, the combination between LVAD and native heart pumping, uniform or pulsatile flow at OG, etc. We have hypothesized that an optimal implantation of LVAD is patient specific. To test this hypothesis, we employ a novel in-house computational modeling technique, named InVascular, to conduct a systematic evaluation of cardiac output at aortic arch together with other pertinent hemodynamic quantities for each patient under various implantation scenarios aiming to get an optimal implantation strategy. InVacular is a powerful computational modeling technique that integrates unified mesoscale modeling for both image segmentation and fluid dynamics with the cutting-edge GPU parallel computing. It first segments the aortic artery from patient’s CT image, then seamlessly feeds extracted morphology, together with the velocity wave from Echo Ultrasound image of the same patient, to the computation model to quantify 4-D (time+space) velocity and pressure fields. Using one NVIDIA Tesla K40 GPU card, InVascular completes a computation from CT image to 4-D hemodynamics within 30 minutes. Thus it has the great potential to conduct massive numerical simulation and analysis. The systematic evaluation for one patient includes three OG anastomosis (ascending aorta, descending thoracic aorta, and subclavian artery), three combinations of LVAD and native heart pumping (1:1, 1:2, and 1:3), three angles of OG anastomosis (inclined upward, perpendicular, and inclined downward), and two LVAD inflow conditions (uniform and pulsatile). The optimal LVAD implantation is suggested through a comprehensive analysis of the cardiac output and related hemodynamics from the simulations over the fifty-four scenarios. To confirm the hypothesis, 5 random patient cases will be evaluated.

Keywords: graphic processing unit (GPU) parallel computing, left ventricle assist device (LVAD), lumped-parameter model, patient-specific computational hemodynamics

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Prakash Dhakal

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Hepatic portal venous gas (HPVG) is diagnosed via computed tomography due to unusual imaging features. HPVG, when linked with pneumatosis intestinalis, has a high mortality rate and requires urgent intervention. We present a case of a 26-year-old young adult with superior mesenteric artery thrombosis who presented with severe abdominal pain. He had a history of COVID vaccination (First dose of COVISHILED) 15 days back. On imaging, HPVG and pneumatosis intestinalis were seen owing to the urgent intervention of the patient. The reliable interpretation of the imaging findings along with quick intervention led to a favorable outcome in our case. Herein we present a thorough review of the patient with a history of COVID-19 vaccination with superior mesenteric artery thrombosis leading to bowel ischemia and hepatic portal venous gas. The patient underwent subtotal small bowel resection.

Keywords: COVID-19 vaccination, SMA thrombosis, portal venoius gas, pneumatosis intestinalis

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Authors: Sebastian Oportus, Fabrizio Alvarez

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3D digitalization of heritage objects is widely used nowadays. However, the most advanced 3D scanners in the market that capture topology and texture at the same time, and are specifically made for this purpose, don’t deliver the accuracy that is needed for scientific research. In the last three years, we have developed a method that combines the use of Metrologic grade laser scans, that allows us to work with a high accuracy topology up to 15 times more precise and combine this mesh with a texture obtained from high definition photogrammetry with up to 100 times more pixel concentrations. The result is an accurate digitalization that promotes heritage preservation, scientific study, high detail reproduction, and digital restoration, among others. In Chile, we have already performed 478 digitalizations of high-value heritage pieces and compared the results with up to five different digitalization methods; the results obtained show a considerable better dimensional accuracy and texture resolution. We know the importance of high precision and resolution for academics and museology; that’s why our proposal is to set a worldwide standard using this open source methodology.

Keywords: 3D digitalization, digital heritage, heritage preservation, digital restauration, heritage reproduction

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Authors: B. N. Emenyeonu

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Initially identified as sensationalism in the eras of yellow journalism and tabloidization, the inclusion of news which shocks or provokes strong emotional responses among readers, viewers, and browsers has not only remained a persistent feature of journalism but has also seemingly escalated in the current climate of digital and social media. Whether in the relentless revelation of scandals in high places, profiles on people displaced by sporadic wars or natural disasters, gruesome accounts of trucks plowing into pedestrians in a city centre, or the coverage of mourners paying tributes to victims of a mass shooting, mainstream, and digital media are often awash with tragedy, tears, and trauma. While it may aim at inspiring sympathy, outrage, or even remedial reactions, it would appear that the deluge of grief and misery in the news merely generates in the audience a feeling that borders on hearing or seeing too much to care or act. This feeling also appears to be accentuated by the dizzying diffusion of social media news and views, most of whose authenticity is not easily verifiable. Through a survey of 400 regular consumers of news and an in-depth interview of 10 news managers in selected media organizations across the Middle East, this study therefore investigates public attitude to the profusion of bad news in mainstream and digital media. Among other targets, it examines whether the profusion of bad news generates empathy fatigue among the audience and, if so, whether there is any association between biographic variables (profession, age, and gender) and an inclination to empathy fatigue. It also seeks to identify which categories of bad news and media are most likely to drag the audience into indifference. In conclusion, the study discusses the implications of the findings for mass-mediated advocacies such as campaigns against conflicts, corruption, nuclear threats, terrorism, gun violence, sexual crimes, and human trafficking, among other threats to humanity.

Keywords: digital media, empathy fatigue, media campaigns, news selection

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Authors: Ahmed A. Khamis, Sherif A. Ibrahim, Mahmoud El Khatieb, Mohamed A. Barakat

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Parametric design is an icon of the modern architectural that facilitate taking complex design decisions counting on altering various design parameters. Double skin facades are one of the parametric applications for using parametric designs. This paper opts to enhance different daylight parameters of a selected case study office building in Cairo using parametric double skin facade. First, the design and optimization process executed utilizing Grasshopper parametric design software which is a plugin in rhino. The daylighting performance of the base case building model was compared with the one used the double façade showing an enhancement in daylighting performance indicators like glare and task illuminance in the modified model, execution drawings are made for the optimized design to be executed through Revit, followed by computerized digital fabrication stages of the designed model with various scales to reach the final design decisions using Simplify 3D for mock-up digital fabrication

Keywords: parametric design, double skin facades, digital fabrication, grasshopper, simplify 3D

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Authors: Laila Al-Balushi, Suad Al-Kharosui

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Due to the increasing number of breast cancer cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19 on bed situation in the hospital, a policy of early discharge (ED) with drain after breast cancer surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up, conducted after discharge and the main mode of communication was Instagram media. This policy then was evaluated by conducting a quasi-experimental study using a questionnaire with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the questionnaire. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after BC surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Keywords: breast cancer, surgery, early discharge, surgical drain

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Authors: Styliani Soulioti, Helen Fiddler

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The aim of this study was to investigate the approaches used by physiotherapists in the education of patients with chronic low back pain (cLBP) and the rationale that underpins their choice of approach. Therapeutic patient education (TPE) is considered to be an important aspect of modern physiotherapy practice, as it helps patients achieve better self-management and a better understanding of their problem. Previous studies have explored this subject, but the reasoning behind the choices physiotherapists make as educators has not been widely explored, thus making it difficult to understand areas that could be addressed in order to improve the application of TPE.A qualitative study design, guided by a constructivist epistemology was used in this research project. Semi-structured interviews were used to collect data from 7 physiotherapists. Inductive coding and thematic analysis were used, which allowed key themes to emerge. Data analysis revealed two overarching themes: 1) patient-centred versus therapist-centred educational approaches, and 2) behaviourist versus constructivist educational approaches. Physiotherapists appear to use a patient-centred-approach when they explore patients’ beliefs about cLBP and treatment expectations. However, treatment planning and goal-setting were guided by a therapist-centred approach, as physiotherapists appear to take on the role of the instructor/expert, whereas patients were viewed as students. Using a constructivist approach, physiotherapists aimed to provide guidance to patients by combining their professional knowledge with the patients’ individual knowledge, to help the patient better understand their problem, reflect upon it and find a possible solution. However, educating patients about scientific facts concerning cLBP followed a behaviourist approach, as an instructor/student relationship was observed and the learning content was predetermined and transmitted in a one-way manner. The results of this study suggest that a lack of consistency appears to exist in the educational approaches used by physiotherapists. Although patient-centeredness and constructivism appear to be the aims set by physiotherapists in order to optimise the education they provide, a student-teacher relationship appears to dominate when it comes to goal-setting and delivering scientific information.

Keywords: chronic low back pain, educational approaches, health education, patient education

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Authors: Dingding Chen, Kazuo Arakawa, Masakazu Uchino, Changheng Xu

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Vacuum assisted resin transfer moulding (VARTM) is a promising manufacture process for making large and complex fiber reinforced composite structures. However, the complexity of the flow of the resin in the infusion stage usually leads to nonuniform property distribution of the produced composite part. In order to control the flow of the resin, the situation of flow should be mastered. For the safety of the usage of the produced composite in practice, the understanding of the property distribution is essential. In this paper, we did some trials on monitoring the resin infusion stage and evaluation for the fiber volume fraction distribution of the VARTM produced composite using the digital image correlation methods. The results show that 3D-DIC is valid on monitoring the resin infusion stage and it is possible to use 2D-DIC to estimate the distribution of the fiber volume fraction on a FRP plate.

Keywords: digital image correlation, VARTM, FRP, fiber volume fraction

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Authors: Tashinga Matindike

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By means of definition, digital artworks encompass an array of artistic productions that are expressed in a technological form as an essential part of a creative process. Examples include illustrations, photos, videos, sculptures, and installations. Within the context of the visual arts, the process of repatriation involves the return of once-appropriated goods. Archiving denotes the preservation of a commodity for storage purposes in order to nurture its continuity. The aforementioned definitions form the foundation of the academic framework and premise of the argument, which is outlined in this paper. This paper aims to define, discuss and decipher the complexities involved in digitising artworks, whilst explaining the benefits of the process, particularly within the South African context, which is rich in tangible and intangible traditional cultural material, objects, and performances. With the internet having been introduced to the African Continent in the early 1990s, this new form of technology, in its own right, initiated a high degree of efficiency, which also resulted in the progressive transformation of computer-generated visual output. Subsequently, this caused a revolutionary influence on the manner in which technological software was developed and uterlised in art-making. Digital technology and the digitisation of creative processes then opened up new avenues of collating and recording information. One of the first visual artists to make use of digital technology software in his creative productions was United States-based artist John Whitney. His inventive work contributed greatly to the onset and development of digital animation. Comparable by technique and originality, South African contemporary visual artists who make digital artworks, both locally and internationally, include David Goldblatt, Katherine Bull, Fritha Langerman, David Masoga, Zinhle Sethebe, Alicia Mcfadzean, Ivan Van Der Walt, Siobhan Twomey, and Fhatuwani Mukheli. In conclusion, the main objective of this paper is to address the following questions: In which ways has the South African art community of visual artists made use of and benefited from technology, in its digital form, as a means to further advance creativity? What are the positive changes that have resulted in art production in South Africa since the onset and use of digital technological software? How has digitisation changed the manner in which we record, interpret, and archive both written and visual information? What is the role of South African art institutions in the development of digital technology and its use in the field of visual art. What role does digitisation play in the process of the repatriation of artworks and artefacts. The methodology in terms of the research process of this paper takes on a multifacted form, inclusive of data analysis of information attained by means of qualitative and quantitative approaches.

Keywords: digital art, digitisation, technology, archiving, transformation and repatriation

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Authors: Khalid Abdelghany

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Additive Manufacturing (AM) is the manufacturing technology that is used to fabricate fast products direct from CAD models in very short time and with minimum operation steps. Jointly with the advancement in medical computer modeling, AM proved to be a very efficient tool to help physicians, orthopedic surgeons and dentists design and fabricate patient-tailored surgical guides, templates and customized implants from the patient’s CT / MRI images. AM jointly with computer-assisted designing/computer-assisted manufacturing (CAD/CAM) technology have enabled medical practitioners to tailor physical models in a patient-and purpose-specific fashion and helped to design and manufacture of templates, appliances and devices with a high range of accuracy using biocompatible materials. In developing countries, there are some technical and financial limitations of implementing such advanced tools as an essential portion of medical applications. CMRDI institute in Egypt has been working in the field of Medical Additive Manufacturing since 2003 and has assisted in the recovery of hundreds of poor patients using these advanced tools. This paper focuses on the surgical and dental use of 3D printing technology in Egypt as a developing country. The presented case studies have been designed and processed using the software tools and additive manufacturing machines in CMRDI through cooperative engineering and medical works. Results showed that the implementation of the additive manufacturing tools in developed countries is successful and could be economical comparing to long treatment plans.

Keywords: additive manufacturing, dental and orthopeadic stents, patient specific surgical tools, titanium implants

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